In recent decades, there has been a revolution in the way mental health concerns are treated and managed. Gone are the days of simply locking away those with mental health concerns – instead, society encourages us to address mental health through the classification of conditions to provide the best form of treatment possible.

Recognising the challenges of contemporary psychiatric models, new research conducted by the British Psychological Society has proposed an alternative model for framing and working through mental health challenges. The Power Threat Meaning Framework (PTMF) redefines how clinicians identify, manage, and support patients through clinical care and attempts to address key concerns about conventional diagnostic models.

For mental health professionals such as therapists, counsellors with a Master of Counselling online degree and psychologists, the PTMF framework can be a step closer to more nuanced, effective care. What are the implications for clinical practice?

The Challenge of Traditional Diagnostics

Historically, mental health care has faced many challenges. In 21st-century Australia, the notion of simply putting a patient in an asylum would be unheard of – in a world where holistic care is king, the idea of 19th-century practices is archaic.

Aussies have put the hard yards into destigmatising healthcare, with events such as Movember and Mental Health Awareness Month helping to foster a culture where it’s OK to talk about mental health and reach out for treatment if required. While recognition of mental health has helped, there are still challenges.

There can be deep social stigmas around mental illness, particularly for those who have been diagnosed and face ongoing challenges around their condition. While legislation exists to protect the rights of those with mental illnesses, a diagnosis or label on its own can often feel like it has consequences, both perceived and actual. While clinically, it may be helpful to label mental health, there are some questions as to whether it actually helps or simply amplifies existing stigmas.

Mental health is a prevalent issue, with recent data from the Australian Institute of Health and Welfare noting that more than one in five Australians have experienced a mental disorder in the past twelve months. Identifying ways to reduce stigma around mental health would not only help with treatment, but it could make a meaningful difference in the way clinicians treat and respond to mental health concerns.

A New Approach to Clinical Care

At the British Psychological Society, a collaboration between mental health professionals and patients has resulted in a framework designed to make meaning out of emotional distress and understand it as a response to the challenges of life rather than labelling symptoms as illnesses.

Introduced in 2018, the Power Threat Meaning Framework (PTMF) seeks to reimagine mental health care. Rather than diagnosis, the framework invites those experiencing emotional distress to explore the decisions that have led up to their distress.

The concept is rather novel – rather than a patient walking out as someone with depression, the PTMF instead acknowledges the unique factors that influence an individual’s mental health, whether they be economic, social, or cultural. This is powerful in that it empowers patients to reframe their mental health struggles as a part of their individual story: rather than being boxed into a label, they can be empowered.

Ultimately, the PTMF may reshape mental health care as we know it.

Key Components of the PTMF

The PTMF has four key elements, each vital to considering an individual’s mental health experiences. These elements help shape patient care in a way that is unique to them so that practitioners can support them meaningfully.

Power examines the role that power dynamics play in shaping one’s experiences and their subsequent impacts on mental health. What are the forms of power, whether they be economic, social, ideological, or cultural, that have shaped a patient’s lived experience, and how has that power been exercised?

Threat recognises that power imbalances can lead to threats — for example, stigma can lead to insecurity or vulnerability. The PTMF encourages practitioners to explore the nature of threats to gain a better understanding of how they impact an individual’s mental health.

Meaning is a critical part of the PTMF. While we all may be exposed to different power dynamics and threats, how we respond as individuals can vastly differ. Finding meaning in an individual’s circumstances allows practitioners to better understand why an individual has responded a certain way during a mental health event.

Finally, the Framework fosters an environment where clinicians collaborate, where mental health is more than patient and practitioner. How can patients use the knowledge they have gained by exploring the framework to shape their own stories?

The Clinical Impact of the PTMF

Considering mental health through the context of the PTMF requires a rethink of how practitioners currently work on mental health care. Rather than diagnosing a condition, the PTMF encourages practitioners to collaborate with patients to discover the unique power structures, threats and impacts that a mental health event has had rather than simply assigning a label and moving on.

If PTMF is implemented more broadly, administrators will need to consider how their structures can support this new model of care. Rather than a checkbox or a diagnostic label, the PTMF encourages greater exploration at an individual level.

While patients may still be there to receive care, reflecting on one’s own experiences is vital to getting the most out of the PTMF. Perhaps, instead of working in a siloed environment, the PTMF will enable greater collaboration through sharing and discovery.

Change, by any stretch of the imagination, takes time. It’s well known that it can take decades for research to become clinical practice, and while the PTMF has shown promise in clinical environments, it will undoubtedly take time for institutions to adopt this alternative method of mental health treatment.

Long gone are the days of simply locking up people experiencing mental distress, but while there has been much work in normalising the role that mental health plays in our society, there are still barriers to overcome.

Could new treatment frameworks, such as the Power Threat Meaning Framework, reimagine how mental health is managed in society? Only time will tell.